Kurt David Wallin, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D008400 Issued in AZ

Practice address

2934 W Ina Rd
Tucson, AZ 85741-2110

Phone

(480) 432-2000

NPI assigned

May 31, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1164716783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3648 E JANELLE WAY",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852984836",
            "telephone_number": "480-432-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2934 W INA RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857412110",
            "telephone_number": "480-432-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "KURT",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-31",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS038653",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D008400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Wallace, PA-C
• Steven B Wallach, D.O.
• Keira Wallenborn, MA, CCC-SLP
• Kaylee Wallentine
• Candice Waller, LPC-MHSP
• Salley A Wallin, LCSW, MSW
• Corinne Elizabeth Wallis, PT, DPT
• Helena Wallis, LMT
• Mara Wallisch, PT, DPT
• Chloe Grace Walls, DMD

• Periodontics in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.